Adenoma detection and subsequent colorectal cancer risk: is the race really over?
A high adenoma detection rate (ADR) is vital for effective colorectal cancer (CRC) screening, but evidence suggests limited additional benefit beyond a certain threshold. In a pooled analysis of five large colonoscopy studies, we confirmed an inverse relationship between ADR and postcolonoscopy CRC risk. In primary screening, an ADR of at least 27% is essential. While higher ADRs further reduce risk, the benefit plateaus beyond 34%, offering minimal added value. Efforts should focus on supporting low-performing endoscopists to meet quality standards. ADR benchmarks in faecal immunochemical test (FIT)-based programmes warrant further investigation.
Authors
- Marco Di Marco (ORCID: https://orcid.org/0009-0003-0225-4602)
- Antonio Facciorusso (ORCID: https://orcid.org/0000-0002-2107-2156)
- Cesare Hassan (ORCID: https://orcid.org/0000-0001-7167-1459)
- Cristiano Spada (ORCID: https://orcid.org/0000-0002-5692-0960)
- Mário Jorge Dinis-Ribeiro (ORCID: https://orcid.org/0000-0003-0121-6850)
- Nastazja Pilonis (ORCID: https://orcid.org/0000-0003-3806-8679)
- Leonardo Frazzoni (ORCID: https://orcid.org/0000-0001-7084-6157)
- Pieter H.A. Wisse
- Manon C.W. Spaander (ORCID: https://orcid.org/0000-0002-9103-9757)
- Angelo De Padova
- Giovanni Barbara (ORCID: https://orcid.org/0000-0001-9745-0726)
- Giulio Antonelli (ORCID: https://orcid.org/0000-0003-1797-3864)
- Evelien Dekker (ORCID: https://orcid.org/0000-0002-4363-0745)
- Michael Bretthauer (ORCID: https://orcid.org/0000-0001-9653-6886)
- Lorenzo Fuccio (ORCID: https://orcid.org/0000-0001-8618-2447)
- F. Orlandini
- Michał F. Kamiński (ORCID: https://orcid.org/0000-0002-9714-6457)
Institutions
- Università Cattolica del Sacro Cuore (IT)
- Oslo University Hospital (NO)
- Humanitas University (IT)
- University of Salento (IT)
- University of Oslo (NO)
- Erasmus MC (NL)
- Agostino Gemelli University Polyclinic (IT)
- Viking Development Group (Norway) (NO)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- Città di Castello Hospital (IT)
- IPO Porto (PT)
- Ospedale Infermi di Rimini (IT)
- Postgraduate School of Molecular Medicine (PL)
- The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
- Amsterdam University Medical Centers (NL)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- University of Amsterdam (NL)
- University of Bologna (IT)
Publication Details
- Journal
- Gut
- Published
- 2025-06-27
- DOI
- https://doi.org/10.1136/gutjnl-2025-335225
- Citations
- 2
- Primary Topic
- Colorectal Cancer Screening and Detection
- Type
- article
- Field-Weighted Citation Impact
- 2.09